Prevalence, risk factors and outcome of delirium in intensive care unit

Vijayalekshmi .S; Krishnadas .N C; Rajmohan Velayudhan; Krishnan .R

Prevalence, risk factors and outcome of delirium in intensive care unit

Original Article

Author Details : Vijayalekshmi .S, Krishnadas .N C, Rajmohan Velayudhan, Krishnan .R

Volume : 4, Issue : 2, Year : 2018

Article Page : 73-77

https://doi.org/10.18231/2455-8451.2018.0019

Suggest article by email

Get Permission

Abstract

Introduction: Delirium causes serious in-hospital morbidity.
Aims: Prevalence, risk factors and outcome of delirium were studied in a medical ICU.
Materials and Methods: This prospective study in the medical ICU identified delirium by CAM (Confusion Assessment Method). Comorbidities were assessed by Charlson Comorbidity Index. Socio-demographics, clinical parameters and outcome required a structured questionnaire. Data was analyzed using chi- square test, Pearson correlation and independent sample t test.
Results: Of 467 patients assessed, 101satisfied CAM diagnosis of delirium (prevalence-21.6%). Females predominated (51.5%); average age was 59.6 years. Acute exacerbation of chronic obstructive pulmonary disease (COPD) was the most common illness, diabetes mellitus (58.4%) followed by hypertension (17.8%) the most common co-morbidities. Leukocytosis, raised serum creatinine and abnormal EEG were observed. 77.2% had nasogastric feeding, 22.8% needed ventilator support.76.2% of patients were on some medication. Delirium was hyperactive in 78.2%, idiopathic in 38.6%. Hypoactive delirium, the least common, was associated with acute pulmonary oedema and sepsis (51.3%). (p=0.009). Delirium resolved completely in 80.2%. Mortality rate was 13.9%. 78.6% patients died within 72 hours (p=0.008); death was increased in those with respiratory findings (p=0.01) and ventilator (p<0.001).
Conclusion: A high prevalence of delirium was found in the Medical ICU. This was mostly hyperactive and idiopathic. Hypoactive delirium, the least common, was found associated with acute pulmonary oedema, sepsis. Acute exacerbation of COPD was the most common cause. Those with respiratory findings and on ventilator had higher mortality.

Keywords: Delirium, Intensive care, Hypoactive delirium, Ventilator, Mortality.

How to cite : Vijayalekshmi .s, Krishnadas .n C, Velayudhan R, Krishnan .r, Prevalence, risk factors and outcome of delirium in intensive care unit. IP Indian J Neurosci 2018;4(2):73-77

This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.